FLUVOXAMINE AND DIVING 2

[Oni]

Read this aricle from Rodale's:

"Antidepressants and Other Psychiatric Medications
What are they? Over the last decade, antidepressants have become some of the most widely prescribed drugs among otherwise healthy people. The most common class of these drugs are Serotonin Selective Re-uptake Inhibitors (SSRIs). These drugs include fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft), among others. Also commonly used are an older class of medications called tricyclic anti-depressants, which includes such medicines as nortriptyline (Pamelor) and amitriptyline (Elavil). Many other anti-depressants are also available, and more come on the market each year.
Potential downside: The effects of pressure and depth on these medications has not been clinically studied, but any drug that affects the brain is a potential problem when combined with nitrogen narcosis. There is also the question of the depression itself. Each year, there are a small number of diving deaths suspected to be suicides. This has the potential to endanger others on the boat if a rescue attempt is made.

Safe for diving? No. While many people on antidepressants may be able to dive perfectly safely, the potential risks are significant and should be discussed with your physician and psychiatric caregiver. In most cases, however, the underlying psychiatric disorder will preclude diving.

Common brand names: Prozac, Paxil, Zoloft. "

Fluvoxamine is a drug I am taking: an SSRI. However, I just had a appointment today with my behavorial pediatrics doctor and he said he doesn't think that Fluvoxamine is harmful when diving. He read the article and says my perticular disorder: Mild Obessive Compulsive Behavior Disorder (OCD) is not anywhere near as serious as depression and that Luvox (currently 175mg) is not harmful while diving, even if you get DCS.

Please clear this contrdicting debate for me.

Im weaning off Luvox an should drop to nothing by July 17th.

Should I cancel my June 30 scuba lessons?

~THX
Oni

 

[John Reinertson]

Each diver has to assess the risks of each dive for that day and time and their personal condition, both psychiatric and physical.

I don't agree completely with Rodales' article conclusions.
I personally feel a patient who is in complete remission, with no symptoms of their illness remaining, and has been stable on medications for a couple months, can dive. In my practice, that probably covers half of my patients on treatment.

Their is little or no known hazard with most of the newer antidepressants.

The major concern is the underlying illness and how well controlled it is.

Many patients with Depression or OCD or Primary anxiety disorder are at increased risk of panic underwater if their illness is not COMPLETELY controlled.

Panic underwater (or even moderate increase in anxiety) can lead to inability to make an appropriate decision in an emergency, which could lead to the death of yourself or a buddy.

I would personally not suggest continuing lessons until you are stable off medication for six months, or stable on medication for six months. The key words are STABLE and IN REMISSION. Residual anxiety attacks or ritual compulsion attacks or Indecision attacks are a potential recipe for disaster. I wouldn't want a student who is tapering their medicine in my class. I wouldn't clear a patient personally for diving if there had been a recent medication change up or down.

Be careful. Diving is relaxing and non-taxing when things are going well, but a dive can turn to crap without warning. Don't dive if you're not certain you're ready for a potential emergency on that day and at that site.

Dive stable and safe,
John Reinertson